Re
vised: 11//2018
Application Addendum Institutions Omitted
DIRECTIONS: This is a fillable form, please download and save it to Adobe (PDF). Once you’ve completed the
form click Submit, it will open your email window with the form as an attachment. The form will go directly to
the Office of Admission at apply@brandman.edu for processing. When emailing the form, please use the
same email address you used on your application or your Brandman University Student email account
(@mail.brandman.edu).
Complete all applicable areas to authorize the Office of Admission to amend your application for admission.
APPLICANT INFORMATION
Last Name First Name Student#:
Email Birth date Campus:
MM/DD/YYYY
Please make the following change(s) to my application for admission:
PREVIOUS COLLEGES ATTENDED: I wish to revise my application to INCLUDE the following colleges to
my list of institutions previously attended:
Name of Institution
Location
(City & State)
Area of Study
Dates Attended:
Degrees Received
FROM
Month/Year
TO
Month/Year
Please explain the reason for omitting institution(s) attended from you application.
ACKNOWLEDGMENT: I understand the consequences of any misrepresentation or omission of
institutions attended on my application may result in denial of admission, rescinding of
admission, suspension, expulsion, rescinding of degree(s) conferred, and repayment of financial aid
funding.
AUTHORIZATION: By submitting the Application Addendum, I certify that I am the individual identified
on this form and to the best of my knowledge, the information furnished on this addendum is accurate
and complete. I authorize the Office of Admission to make the changes listed to my original application.
Applicant Signature: Date:
Print Name MM/DD/YYYY
Submit
click to sign
signature
click to edit
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